Please take the time to have your parent or gaurdian fill this form out. Without this form completed, you will not be allowed to participate in the Trip to the Ramp on October 17th 2020.

Release of Liability/Church Activity

Parent Name

First Name

Last Name

Email

Please read and complete form

RELEASE OF LIABILITY/CHURCH ACTIVITIES I am the parent or guardian of_____________________________________, a minor child. As such parent or guardian, I do hereby release Life Chapel Inc./Student/Children’s Ministry of Rainsville, AL and responsible workers from any and all claims, causes of action or liabilities for injuries of any kind occurring while going to, coming from or during the minor’s trips with church approved personnel. I authorize Life Chapel Inc./Student/Children’s Ministry The bearer of this consent to obtain such medical care for the said minor. Whether it be emergency care or otherwise, as the bearer deems necessary. I present Life Chapel Inc./Student/Children’s Ministry and all providers of medical care that the said minor has the following known allergies and important medical conditions. _____________________________________________________________ I understand that this consent form gives my permission for the above stated minor to go on trips with Life Chapel Inc./Student/Children’s Ministry for 2020. (Parent or guardian signature and date)

Parents written consent

Please type in your child/s name and your direct consent for he/she to join on this Youth Trip on the date of Oct 17th 2020.

Checkbox a box

I am the guardian of the above named child.

I am the parent of the above named child.

Important Info (Medication/Allergies/etc.)

Childs Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone

(###)

###

####

Trip Details:

Leaving around 1 or 2pm Saturday (specific time TBA) and going for service at the Ramp at OCI in Cleveland TN.

Service starts at 6 TN time. We will stop for food before service. No definite time of return, in Rainsville but we will head back when the service is over.

Leaders/Care takers are Kim Corbin, Honey Holcomb, Ron & Christie Shrader, and myself Katie Kirtland.

Ramp Youth Trip

Love Life | Girls Night In | with Joyce Meyer

Bryant Baby Shower